BackgroundPharmaceuticals have made an important contribution to global reductions in morbidity and mortality. To help save lives and improve health, it is important to be sure about equity to access to drugs, drug efficacy, quality and safety, and rational use of drugs, which are standardized National Drug Policy NDP objectives. NDP-s indicators are useful to evaluate the pharmaceutical system performance in a country. Iran has adapted a National Drug List NDL. Since management of drug supply in Iran takes place only for drugs that have been selected in NDL and this list is selected by the member of Iran Drug Selecting Committee IDSC, thus evaluation of IDSC-s decision making during last 5 years is an appropriate way to evaluate the implementation of drug supply system in the country.

MethodsTo identify strengths and weaknesses of pharmaceutical policy formation and implementation in Iran, four standard questionnaires of the World Health Organization WHO were used. To assess the agreement between decisions of IDSC and standardized NDP indicators in the last 5 years 1998–2002, a weighted questionnaire by nominal group technique based on the questions that should be answered during discussion about one drug in IDSC was designed and used.

ResultsThere is a totally generics based NDP with 95% local production, that provides affordable access to drugs. The system, structures, and mechanisms were in place; however, they did not function properly in some topics. Assessment of 59 dossiers of approved drugs for adding to NDL during last 5 years showed that IDSC-s members pay more attention to efficacy, safety, and rationality in use rather than accessibility and affordability.

ConclusionRevision of drug system in term of implementation of the processes to achieve NDP-s objectives is necessary to save public health. Clarification of NDP-s objectives and their impact for IDSC-s members will result in improvement of the equity in access to pharmaceuticals.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-698X-5-5 contains supplementary material, which is available to authorized users.